I am a licensed acupuncturist in the state of Oregon struggling to make ends meet in my practice with continuing insurance reimbursement decreases. Not only has the financial rate decreased, but the quantity of treatments has been restricted. It has been getting increasingly more challenging to provide quality care with insurers’ “quality control measures.” My cost of doing business has not decreased, and patients’ ability to pay cash has decreased. Perhaps the patient should be asked about their preference of treatment for chronic back pain; for example — a year’s worth of weekly acupuncture and physical medicine versus an MRI?

William J. Ryder; Quincy, Mass.

Isn’t the whole point of using science in health care, and in passing laws to make health care safe and efficient, to “discriminate” by choosing treatments that work and providers who are trained in such systems? Naturopaths can only be advanced by politics and anecdotes. The science on their approaches shows that most [treatments] either don’t work or are [based on] lifestyle advice already incorporated into the work of primary care providers. The truth is that naturopaths don’t drop treatments that are popular but ineffective. Do we need such dalliance and waste as we try to advance health care access and quality?

While rates may even out over time, this article is underplaying the initial “rate shock” that will be felt by the young and healthy on individual and group policies. It doesn’t help that on the eve of the exchanges/marketplace rollout, Congress has decided to back off its promise to participate in the exchanges for its members and staff. I am a broker in the small group market where most employers contribute 50 percent of the individual rate. From what I understand, we taxpayers appear to be footing the bill to cover 75 percent — at least — of congressional members’ and their staff’s individual coverage; who knows what the federal employee contributions might be. Holding our public officials accountable to operate in the “real” world might help them to begin to understand the impact of the policies they enact on the engine of our economy that is the entrepreneur.

Vince Phillips; Mechanicsburg, Pa.

Regarding the observation that changes in health premiums won’t affect you at all, I question the author’s reasoning that most get insurance through larger groups and thus premium hikes won’t affect them. Au contraire, of course it will. The health insurance premium tax will be passed through and the change to eliminate medical underwriting, the limited age rate bands and other market changes beginning in 2014 will have an impact on the employer’s bottom line and, ultimately, the employees if the employer chooses to pay a fine (I can’t afford this anymore) and drops health coverage. The surcharge for smokers will also have an impact.

Since when does the government have the right to tell hospitals how often they can re-admit someone? This is the biggest power grab by our federal government I’ve ever seen. It should be up to the doctor and hospital to decide [when] re-admissions are necessary!!! In some parts of the country, people may wait too long before they go in to get treated. And consequently, they might have to be re-admitted because the first hospital stay did not get an illness in “check.” There are all kinds of reasons for re-admission. … What would our government know about such things?

I was surprised that … [Andrews] failed to mention or advise the readers to check the network of each plan. Our analysis of the plans on Covered California, for example, revealed low cost plans with small, or patchwork-type networks of care, which a reader could discern quickly by using the “find-a-doctor” link on the plan sites as they are shopping. Might want to bring that up next time.